Community-onset candidemia at a university hospital, 1995-2005.

摘要: Background and purpose Although not all candidemias are hospital-acquired, data on clinical epidemiology for the community-onset candidemia limited. This retrospective study was conducted to describe predisposing factors outcomes of candidemias. Methods Medical records patients who were admitted National Taiwan University Hospital between January 1, 1995 May 31, 2005 had Candida isolated from their blood in outpatient setting and/or within 48 h hospitalization (community-onset) reviewed. Results A total 56 episodes reviewed, which included 8 (14.3%) true community-acquired occurring with no record previous 30 days without histories invasive procedures either just before or at time admission, (85.7%) that health care-associated. The latter 24 (42.9%) recently discharged hospitals (within 2-30 current admission), 23 (41.1%) associated central intravascular lines placed therapy, 1 episode (1.8%) nursing homes. Gastrointestinal bleeding (46.4%), immunosuppressive therapy antibiotics use (37.5%) most common factors. Diabetes single important factor (62.5%) a significantly higher prevalence among these than those care-associated (p=0.035). albicans isolate (39.7%), followed by tropicalis (22.4%) glabrata (17.2%). overall case fatality rate 55.4% (31/56), 58.1% (18/31) this attributable candidemia. Multivariate analysis identified severity score lack antifungal as having an independent adverse influence outcome. Conclusions Up 85.7% There is conceptual practical need new classification spectrum acquisition infection, wherein category infection will have implications selection empirical therapy.